Updated on 11/02/2021

CY 2022 Medicare Home Health Final Rule Published

Moments ago, the Centers for Medicare & Medicaid Services (CMS) published the CY 2022 Medicare home health final rule, which goes into effect on January 1, 2022. Click here to view the rule.

The following is CMS’ summary, which will be the focus of HCAF’s upcoming Fall Home Care Connection live virtual event with a comprehensive analysis by Healthcare Provider Solutions CEO Melinda Gaboury. For your convenience, this program is being offered twice:

HCAF staff is in the process of analyzing the rule. Please stay tuned for more information and register now to join us later this month to learn more and get your questions answered!

SUMMARY:

This final rule updates the home health and home infusion therapy services payment rates for calendar year (CY) 2022 in accordance with existing statutory and regulatory requirements. This rule also finalizes recalibration of the case-mix weights and updates the functional impairment levels, and comorbidity adjustment subgroups while maintaining the current low utilization payment adjustment (LUPA) thresholds for CY 2022.

Additionally, this rule finalizes a policy to utilize the physical therapy LUPA add-on factor to establish the occupational therapy add-on factor for the LUPA add-on payment amounts and makes conforming regulations text changes to reflect that allowed practitioners are able to establish and review the plan of care. It also finalizes proposed changes to the Home Health Quality Reporting Program (QRP) including finalizing proposed measure removals and adoptions, public reporting, and modification of effective dates. It also finalizes proposed modifications to the effective date for the reporting of measures and certain standardized patient assessment data in the Inpatient This document is scheduled to be published in the Federal Register on 11/09/2021 and available online at federalregister.gov/d/2021-23993, and on govinfo.gov Rehabilitation Facility (IRF) QRP and Long-Term Care Hospital (LTCH) QRP.

In addition, this final rule codifies certain Medicare provider and supplier enrollment policies. It also makes permanent selected regulatory blanket waivers related to home health aide supervision that were issued to Medicare participating home health agencies during the COVID-19 public health emergency (PHE), and updates the home health conditions of participation regarding occupational therapists assessment completion to implement provisions of the Consolidated Appropriations Act, 2021 (CAA 2021). This final rule also finalizes proposals to expand the Home Health Value-Based Purchasing (HHVBP) Model and to end the original HHVBP Model one year early.

Lastly, it establishes survey and enforcement requirements for hospice programs as set forth in the CAA 2021; and finalizes revisions to the infection control requirements for long-term care (LTC) facilities (Medicaid nursing facilities and Medicare skilled nursing facilities, also collectively known as “nursing homes”) that will extend the mandatory COVID19 reporting requirements beyond the current COVID-19 PHE until December 31, 2024. DATES: These regulations are effective on January 1, 2022.

Article published by HCAF on November 2, 2021

More Information:

Understand The PDGM Case-mix changes and how they affect your agency.
Understand The PDGM Case-mix changes and how they affect your agency.